MANAGEMENT OF UPPER LID ENTROPION: THE AUTHOR HAS NO LONG TERM - - PowerPoint PPT Presentation

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MANAGEMENT OF UPPER LID ENTROPION: THE AUTHOR HAS NO LONG TERM - - PowerPoint PPT Presentation

Jul 08, 2023 363 likes •434 views

12/4/2015 MANAGEMENT OF UPPER LID ENTROPION: THE AUTHOR HAS NO LONG TERM OUTCOMES PROPRIETARY INTERESTS TO DISCLOSE OPHTHALMOLOGY UPDATE 2015 UCSF STUART R. SEIFF, MD, FACS* TRICHIASIS DAVID RUSSELL, MD HISTORICALLY, INTERNATIONAL

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THE AUTHOR HAS NO PROPRIETARY INTERESTS TO DISCLOSE MANAGEMENT OF UPPER LID ENTROPION: LONG TERM OUTCOMES

OPHTHALMOLOGY UPDATE 2015 UCSF

UCSF/CPMC OCULOFACIAL PLASTIC SURGERY

STUART R. SEIFF, MD, FACS* DAVID RUSSELL, MD

*EMERITUS PROFESSOR OF OPHTHALMOLOGY UNIVERSITY OF CALIFORNIA SAN FRANCISCO CONSULTANT, OCULOFACIAL AND AESTHETIC PLASTIC SURGERY CALIFORNIA PACIFIC MEDICAL CENTER

TRICHIASIS

HISTORICALLY, INTERNATIONAL LEADING CAUSE OF BLINDNESS DUE TO CICATRICIAL ENTROPION AND MISDIRECTED LASHES TRACHOMA OCULAR PEMPHIGOID STEVENS JOHNSON

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UPPER LID TRICHIASIS

  • MISDIRECTED LASHES
  • ABERRANT LASHES
  • CICATRICIAL ENTROPION

– WE DO NOT SEE INVOLUTIONAL UPPER LID ENTROPION DUE TO HEIGHT OF TARSUS

MISDIRECTED/ABERRANT LASH MANAGEMENT

  • (EPILATION)
  • LASER, CRYO, ELECTROLYSIS
  • LID SPLITTING WITH FOLLICLE

REMOVAL

  • SEGMENTAL LID MARGIN

RESECTION

  • AVOID CREATING MORE SCAR,

INFLAMMATION, TRICHIASIS

UPPER LID ENTROPION UPPER LID ENTROPION

  • MR COLLIN’S ALGORITHM IS

EXTREMELY THOUGHTFUL

  • UNFORTUNATELY, TOO MANY

RECURRANCES WITH LESS AGGRESSIVE PROCEDURES

  • THEREFORE BEGAN COMBINING

BEST FEATURES OF MANY PROCEDURES….

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TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT

AM JL OPHTHALMOL 1999;127:67-71

TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT

  • AGGRESSIVE PROCEDURE
  • NO GRAFTING
  • OVERCORRECTION OF MARGIN

– TAKE ADVANTAGE OF CICATRICIAL PROCESS

  • CAUTION PT ABOUT ABNL

APPEARANCE 1 MONTH

  • HEALS VERY NICELY WITH TIME

TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT

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TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT

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TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT

TARSAL MARGIN ROTATION WITH POSTERIOR LAMELLA SUPERADVANCEMENT PRE-OP

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POST OP

1 MO POST OP 2 MO POST OP

LONG TERM OUTCOME

  • 30 LIDS IN 22 PATIENTS
  • MEAN AGE 69.57 Y (+/- 18.3)
  • MALE 46%; FEMALE 54%
  • MEAN F/U 52 M (+/- 44.46)
  • NO RECURRANCE ENTROPION

– 9 CASES OF PERSISTENT LASH ABNL – ALL TREATED SUCCESSFULLY

SUMMARY

  • CICATRICAL UPPER LID ENTROPION

IS THE CAUSE OF SIGNIFICANT OCULAR MORBIDITY WORLDWIDE

  • TARSAL MARGIN ROTATION WITH

POSTERIOR LAMELLA SUPERADVANCEMENT HAS DEMONSTRATED LONG TERM SUCCESS IN MANAGEMENT VIA A STRAIGHTFORWARD PROCEDURE

THANK YOU